替罗非班对经皮冠状动脉介入术后患者心肌标志物及心功能的影响

Influence of Tirofiban on Cardiac Biomarkers and Heart Function in Patients with Acute ST Elevation Myocardial Infarction Treated by Emergent Percutaneous Coronary Intervention

目的:探讨替罗非班对急性ST段抬高型心肌梗死(STEMI)诊经皮冠状动脉介入(PCI)治疗后,患者心肌生化标志物及心功能的影响。方法:104例STEMI患者随机分为观察组与对照组,每组52例,均给予急诊经皮冠状动脉介入术(PCI)治疗,术后对照组给予常规治疗,观察组在对照组基础上加用替罗非班治疗,对比两组患者治疗后血小板聚集率、血清肌酸激酶同工酶(CK-MB)水平、肌钙蛋白Ⅰ水平、心肌梗死溶栓治疗(TIMI)分级、心电图ST段回落情况、左室射血分数(LVEF)、不良心血管事件(MACE)发生率。结果:治疗后两组患者CK-MB水平、肌钙蛋白Ⅰ水平及血小板聚集率、TIMI分级、LVEF均显著优于治疗前,观察组显著优于对照组(P<0.01);观察组治疗后ST段回落幅度显著优于对照组(P<0.01),治疗后MACE发生率显著低于对照组(P<0.05)。结论:替罗非班可能能够通过抑制血小板聚集,有效改善PCI术后患者心肌生化指标及心功能。

Objective： To discuss the influence of tirofiban on cardiac biomarkers and heart function in patients with acute ST elevation myocardial infarction （STEMI） treated by emergent percutaneous coronary intervention（PCI）. Methods： 104 patients with acute STEMI were randomly divided into the observation group （n = 52） and the control group （n = 52）, all the patients were treated by PCI, post- operatively the control group was given conventional therapy and the observation group was given tirofi- ban based on the control group, then the cardiac biomarkers and heart function indexes were compared between the two groups. Results： There were no significantly difference in CK-MB, Troponin I, plate- let aggregation, IRA perfusion, and LVEF between the two groups before the treatment （ P 〉 0.05 ）, but after the treatment they were significantly better than before, the observation group was significantly better than the control group（P 〈0.01 ） ; Magnitude of ST-segment of the observation group was signif- icantly better than the control group after treatment （ P 〈 0.01 ） ; MACE rate of the observation group was significantly lower than the control group after treatment （ P 〈 0.05 ）. Conclusion： Tirofiban can effectively improve IRA complex vascular flow rate, biochemical markers, cardiac function, disease prognosis through inhibition of platelet aggregation in patients with STEMI after PCI, itg worthy of pro- motion.